CPCR BLS Flashcards
Who is most at risk of cardiac arrest?
Trauma Systemically unwell Paediatrics Geriatrics Iatrogenic (e.g. anaesthetic overdose) Recently arrested
Describe respiratory arrest.
The patient is not breathing - apnoea
Describe cardiac arrest/cardiopulmonary arrest.
Patient has no cardiac output
Will also not be breathing
What are we aiming to achieve with CPCR?
Perfusion of heart, lungs and brain
ROSC (return of spontaneous circulation)
When do we start CPCR?
As soon as we think the patient has crashed
Respiratory arrest will quickly lead to cardiac arrest
How can we be prepared for a crash?
Regular CPCR training
Crash kit/box/trolley
Crash alarm (call for help)
What is basic life support vs advanced life support?
BLS = CPCR cycle, oxygen therapy ALS = drug therapy, fluid therapy, cardioversion
What things would be useful to have in a crash box?
Airway access e.g. ET tubes, laryngoscope, tube tie, cuff inflator, lidocaine (cats)
IV and IO access e.g. IV catheters, IO needle, IV/IO connectors, superglue, tape, scissors, scalpel blade
Ventilation e.g. paediatric and adult ambu-bag, capnograph connectors, flow regulator
Drugs e.g. adrenaline, atropine, dextrose, propofol, naloxone, dosing charts, ECG pads, 0.9% NaCl drawn up into 10ml syringes
What additional equipment can be useful during a crash?
Capnography
Crash record chart
ECG machine
Defibrillator and conduction gel
What are the two types of external cardiac compressions?
Cardiac pump (cats and small dogs) = compression of thorax directly over heart Thoracic pump (med-large breed dogs) = compression of widest point of thorax, caudal thorax or over xiphysternum
How do we carry out external cardiac compressions?
Ideally in right lateral recumbency
Compressor on dorsal side of patient
Rate = 100-120 compressions per min
Compress 50% - 2/3rds width/depth of thorax
Need to be able to feel a femoral pulse for every compression
Allow for full elastic recoil of chest between compressions
When might we do direct inter-thoracic cardiac compressions?
Large breed dogs
At thoracotomy
When external compressions are not effective
How do we carry out IPPV?
Rate = 20 breaths per min
As soon as you suspect respiratory arrest, commence ventilation
Inflate the thorax the ‘normal’ amount for that patient (although less may be safer)
What should we be considering in the aftermath of a crash?
Patient has potential to re-arrest Treat original condition/cause Communicate with owners Very upsetting/stressful for personnel involved Debriefing can be helpful
